Tag Archives: animal

This past year, the American Counseling Association Governing Council endorsed formal competencies for the practice of animal-assisted therapy in counseling. The authors of the standards, and the coordinators of ACA’s Animal-Assisted Therapy in Mental Health Interest Network, contend that the competencies (available at counseling.org/knowledge-center/competencies) represent a key step forward in both the protection of clients and the promotion of therapy animals’ well-being. My own contention is that the adoption of these competencies additionally points to a need for ACA to endorse a “duty to protect” that applies to animals.

As a doctoral student in counselor education and supervision at University of the Cumberlands in Williamsburg, Kentucky, one of my areas of interest is animal-related counseling issues. I have become increasingly convinced that the human-animal bond is for many people an integral aspect of wellness, recovery, purpose and hope. Furthermore, I contend that it is misguided for the counseling profession to advocate for the protection of animals that we happen to use in our interventions but to take no stance in the protection of other animals whose lives are intertwined with the people we serve. Anecdotally, I have encountered significant support for this sentiment, both within and outside of the counseling profession. I offer a rationale for it here, not merely as a philosophical concept to be considered hypothetically, but as an invitation and a call to action for ACA decision-makers.

Tracing back to the Hippocratic oath, doctors and mental health counselors are required to maintain the confidentiality of information disclosed to them in the context of the therapeutic relationship. An exception for counselors is their “duty to protect” potential victims from the anticipated violent behavior of a client. I’d like to make the case that a client’s anticipated violence toward animals ought to be included on the counseling profession’s list of actions that require mandatory reporting.

Applying counseling’s code of ethics to animals

Animals are already protected by existing state, national and international laws, and I think that adapting the ACA Code of Ethics to reflect adherence to those laws is both a logical extension of our ethical framework and in keeping with the spirit of our duty to report.

The intention of mandated reporting, dating back to the California Supreme Court’s landmark 1974 Tarasoff ruling (amended in 1976 to replace “duty to warn” with “duty to protect”), was to impose a legal obligation on psychotherapists to notify individuals who might potentially become victims of violence perpetrated by a counselor’s client.

The ACA Code of Ethics names “serious and foreseeable harm” (Standard B.2.a.) as an exception to maintaining confidentiality. In full, the standard reads: “The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues.”

To elevate that standard to afford protection to nonhuman victims, it could be amended to read, “… clients or identified others, including animals protected from cruelty by applicable state laws …” Imagine the profound impact our profession could have on alleviating undue suffering with the addition of those nine words. Our responsibilities as counselors would remain essentially just as they are, but without a pass for ignoring instances of “serious and foreseeable harm” to animals protected by law. The ACA Governing Council’s endorsement of competencies that, in part, safeguard the comfort and well-being of animals used in therapeutic interventions is laudable; extending those concerns to protect the most defenseless victims from the most egregious acts of cruelty seems to me to be a reasonable and much-needed next step.

It is worth noting that animal protection laws vary considerably from state to state. For instance, according to the Animal Legal Defense Fund, all but two U.S. states impose felony-level penalties for severe forms of animal abuse, and some states allow for the inclusion of animals in domestic violence protection orders. Additionally, some states require mental health evaluations or counseling for animal-abuse offenders. My proposed amendment to our ethics code is intended to be both comprehensive and flexible enough to accommodate the multitude of variations in state laws.

A likely objection to this suggested modification to our code of ethics might involve concerns about damaging client-counselor rapport. However, the same philosophical justification that applies to our current “duty to protect” mandate applies here too. The amended code would simply reflect the standard established by existing law by identifying and protecting those against whom acts of violence constitute legal violations. As it stands now, the ACA Code of Ethics does just that by protecting humans from illegal acts of violence, but it in effect flouts the law when it comes to protecting animals.

In addition to reconciling this disparity in our duty to report, this amendment would be congruent with our duty to take seriously behaviors that are likely to place both the client and the victim in harm’s way. After all, as counselors, we would be hard-pressed to conceive of the therapeutic value of not intervening in the commission of a violent crime. In the case of child abuse, for instance, it would neither contribute to the protection of the victim nor to the progress of the perpetrator to not treat the crime as being of paramount and urgent importance. The same can be said for the significance and immediacy of animal cruelty.

Extending our duty to report to include acts of animal cruelty is a logical and consistent next step because, unlike with other criminal acts (knowledge of which does not warrant breaching confidentiality), animal cruelty is a crime that involves intentional bodily harm. From that perspective, our failure to include it in our duty to report would seem an ethically arbitrary exclusion.

Clinical implications of animal cruelty

Entities such as the U.S. Department of Education, the National Crime Prevention Council and the American Psychological Association agree that cruelty against animals is a warning sign for at-risk youth. Since 1987, the American Psychiatric Association has included animal cruelty as a symptom of childhood conduct disorder in its Diagnostic and Statistical Manual of Mental Disorders. It defines the disorder as a “repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.” According to the American Psychiatric Association, additional implications of such tendencies include an increased likelihood for exhibiting similar symptoms in adulthood, sometimes resulting in meeting the criteria for antisocial personality disorder.

Dating back to the early 1960s, researchers have strived to clarify the role that childhood animal cruelty might play as a predictor of subsequent violence against humans. John Macdonald sampled 48 patients with psychotic symptoms, and 52 without. He determined that three primary characteristics — fire setting, enuresis and childhood cruelty toward animals — were consistently discovered among the individuals considered to be the most sadistic. Although he concluded that this combination of traits could serve as a strong predictor of homicidal behavior, he noted that the presence of this triad alone was of minimal value in foretelling such acts.

More recent scholarly literature has increasingly suggested evidence for a connection between animal abuse and either co-occurring or subsequent forms of interpersonal violence. Researchers are divided over the legitimacy of this supposed link. In 2001, Frank Ascione published a thorough overview of psychological, psychiatric and criminological research linking animal abuse to acts of violence against humans. He asserted that animal abuse is an often overlooked warning sign that, in addition to helping to identify youth who are themselves victims, “could help identify youth at risk for perpetrating interpersonal violence.” In 1997, Ascione and colleagues also examined the prevalence with which victims of domestic violence report various forms of cruelty perpetuated by their abusers toward their pets. In 2008, Christopher Hensley and Suzanne Tallichet emphasized an exploration of the motivations behind animal cruelty by interviewing inmates about their childhood animal cruelty crimes.

These and myriad other studies have been met with a range of criticisms, from failing to establish a verifiable link between human and animal violence to applying flawed methodologies. Regardless of what one may think of the reliability or validity of the research to date, a wholesale dismissal of the apparent relationship between animal cruelty and violence against humans seems unwise. More important, however, is that the strength of this proposal does not rest on the legitimacy of such data. Reliance on the supposed link unnecessarily detracts from the central argument that a wanton act of cruelty against a defenseless other is, on its face, egregious enough in my opinion to trump a counselor’s duty to protect a client’s confidentiality.

Why amend our duty to report?

The most obvious beneficiaries of this change in the short term would, of course, be those animals who stand to be spared from enduring abusive acts. But is it not also in the long-term interest of the perpetrator, at least potentially, to have the opportunity for reform sooner rather than later? Cultural anthropologist Margaret Mead famously commented in 1964 that cruelty toward animals “could prove a diagnostic sign, and that such children, diagnosed early, could be helped instead of being allowed to embark on a long career of episodic violence and murder.”

Furthermore, is it not ultimately in the interest of the counseling profession as a whole to err on the side of empathy for the most vulnerable and to draw an ethical distinction between the importance of confidentiality and the urgency of violent crime? Are we not all made better by extending and explicitly endorsing the reach of our ethical consideration to protect even (and, indeed, especially) those with no voice in the matter? Although none of us is currently prohibited from reporting acts of animal cruelty, I have no doubt that adding the amendment proposed here to the ACA Code of Ethics would over time contribute to the prevention of incalculable instances of undue harm.

As counselors, we are called to reflect on the broader implications of our work and on how the changes we help to facilitate contribute to a healthier quality of life. That means considering broadly the wellness of people and, from my viewpoint, the animals with whom people’s lives are so frequently intertwined. ACA’s historic endorsement of competencies for animal-assisted therapy is a heartening step forward as we adjust continually to the social, cultural and philosophical shifts of our times. I hope we will seize on the momentum of this achievement by embracing an amendment to our ethics code that is consistent with our recent progress.

This proposed amendment is consistent with our profession’s historically responsive adjustments to the societal implications of our work and to our forward-thinking recognition of the impact it can have on the world around us. As with past adjustments made to our ethics code, it is incumbent on mental health professionals to remain at the forefront of measures aimed at cultivating justice and advocacy in our service to others. The amendment proposed here would be one more step in the spirit of that legacy.

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Troy Gregorino is a licensed professional counselor and certified wellness counselor.
He is a doctoral student in counselor education and supervision at University of the Cumberlands. Contact him at tgregorino@gmail.com.

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having your article accepted for publication, go to ct.counseling.org/feedback.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

“Until one has loved an animal, a part of one’s soul remains unawakened.” — Anatole France

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On Jan. 22, following a three-week whirlwind diagnosis and decline, my husband and I said goodbye to our 6.5-year-old goldendoodle, Lily. Her disease had rendered this Frisbee-catching superstar unable to stand or walk. She needed to be carried outdoors to “get busy,” and she no longer had the stamina to stay awake for extended periods of time.

The author, Cheryl Fisher, with her dogs Max and Lily.

We spent the entire last weekend with Lily in the emergency room as she struggled against various gastrointestinal issues and, finally, internal bleeding. Her vet and neurologist felt that the disease had progressed and her prognosis was bleak. It was then that we made the most difficult decision we have ever made — to let her go. We took time lying with her, holding her, reminiscing … and stayed with her until her last heartbeat.

On the first day without our Lily, I kept tripping over my grief as I called out to see if she needed to go outside or wanted to lie by the window and watch “her birds.” Max, our 9-year-old goldendoodle, moped around the house, trying to sniff Lily out without success. He looked at me as if begging, “Bring her back, OK?” I canceled my clients for the day. I couldn’t imagine sitting with their pain as my pain continued streaming from my eyes.

I found myself returning to the little Catholic girl inside of me and lighting a candle next to a picture of our Lily that I had placed on the fireplace mantle. I wrote, announcing our loss to all 210 close friends on social media. I started a scrapbook and printed pictures long held captive in my iPhone. I cried continuously, as if the floodgates had been lifted and years and layers of grief came pouring out. All the losses in my life appeared to be resurrected with Lily’s death. My heart ached and my stomach hurt.

My attempts to prep for my classes that week proved futile. I just couldn’t concentrate. I kept reading the same sentence over and over again. Mostly I was just tired. Tired from three weeks of relentless caregiving, painstakingly attempting to keep the horrific disease at bay — the disease that stripped my beautiful bird-watching, tail-wagging, never-had-a-bad-day rescue pup of her mobility, energy and dignity. In the end those soulful eyes would beg me to end her suffering, and in keeping the promise I had made to her, I mercifully did, holding her till the end.

Tips for coping with the loss of a pet

Experiencing the death of a pet can be painful and devastating. Our pets are often our most vulnerable family members, relying on us completely for their care. This includes end-of-life care, which may involve making very difficult decisions about treatment and finally letting go. This adds complexity to grief because we may struggle with questions surrounding the decision to stop treatment and euthanize: Did I do enough? When is it time to let go?

1) Grief comes in waves. Initially the waves may be intense and relentless, pummeling us to the ground. We may feel that we will never breath (or stop crying) again. But with time and some work, the waves gradually recede, allowing us to stand and take tentative strides toward a “new normal.” Still, the waves will come and go, often crashing near a special day or at a moment when our dear fur-family member comes to mind.

2) Grief is brain work. Grief affects our neurology. It makes it difficult to concentrate. We forget things. We are easily irritated. We definitely are not on our A game. We may even feel like we are in a dream (or nightmare). Neurologically, we have taken a hit and require time to recover. Don’t worry. The grief fog will lift eventually. In the meantime, be gentle and kind with yourself.

3) Grief is an ever-changing chameleon. Elisabeth Kübler-Ross identified stages of grief related to dying that can also be applied to our experiences of grief and loss. These stages are no longer thought to happen in a linear manner. Rather, they are common experiences that can occur moment to moment as the result of grief.

Anger: Initially, I felt anger at the sudden deterioration of Lily. She had been running and playing catch just days before her back legs began to buckle under her body. Following an MRI and spinal taps, she was placed on a steroid treatment that quickly led to weight loss and gastric-intestinal discomfort. I was angry at the doctor. I was angry at the disease. I was angry at God.

Guilt: Although I knew I had responded quickly to Lily’s symptoms, I was plagued with self-doubt around the decision to use steroid treatment. Should we have gotten a second opinion? Should we have taken her to a holistic veterinarian? Ultimately, I ruminated over our decision to stop all care and put her to sleep. Was there more that we could have done? It was profoundly clear that the disease had progressed and Lily’s quality of life had suffered drastically, but I still experienced pangs of guilt.

Denial: The first few days were the most grueling. Walking in a daze, I still held some hope that this was all just a nightmare, and as I tripped over Lily’s misplaced toy, I would awaken to find both of our dogs curled at the foot of the bed.

Sadness: It is immensely sad to lose a love one — even a curly headed, wet-nosed, tail-wagging one. I am free with my tears in general, so I just let the emotions stream down my cheeks. Sadness, like grief, looks different for each individual. I am an emotional griever. I emote. My husband is an instrumental griever. He does research on the internet to seek answers. He walks our dog, schedules doggie play dates and arranges activities to help our other dog, Max, with his grief.

Acceptance: Ultimately, the hope is that there will be a sense of peace and understanding at some point and time. This may be experienced in fleeting moments rather than in an arrival at a destination, however.

4) Grief is individual. For me, Lily’s death overshadowed any other event occurring in the world. My Lily had died. Nothing else mattered to me. I crafted my coping strategy selfishly without concern for the feelings or needs of anyone else, including my husband, who had experienced the same loss.

It quickly became apparent that my grieving was more expressive and ritualistic. I made a scrapbook, displayed sympathy cards on the mantle with Lily’s urn, wrote blogs and lit candles in memory of our little rescue. My husband’s grief was more privately experienced, with an occasional shared story and shed tear. It was important not to trip over each other’s grief experience.

5) Grief grows out of a relationship. Some people (and even some therapists) may dismiss the death of a pet as a lesser loss. However, as with any relationship, it is important to understand the meaning ascribed to this relationship. Often a pet serves as a companion who provides unconditional love and affection. Many clients have told me stories of the richness and depth that surrounded their interactions with their pets. For me, Lily was the piece that completed our family puzzle.

Conclusion

The death of a pet can be such a huge loss. These fur-family members may serve as faithful friends and playmates, enriching our lives with their magnificent and comical personalities. It is important to honor their story as it intertwines with our own narrative.

I still tear up every time I hear Eva Cassidy’s version of “Somewhere Over the Rainbow.” I imagine my curly white bundle of pure love bounding across a green field to greet me … just around the Rainbow Bridge.

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Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland, and a visiting full-time faculty member in the Pastoral Counseling Department at Loyola University Maryland. Her current research examines sexuality and spirituality in young women with advanced breast cancer. She is working on a book titled Homegrown Psychotherapy: Scientifically Based Organic Practicesthat speaks to nature-based wisdom. Contact her at cyfisherphd@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Have you received a telephone call of the following nature? “Can you certify my pet to be an emotional support animal?”

If you are a professional counselor, then the likelihood of you receiving such a request is on the rise. This is because word is spreading that the U.S. Department of Housing and Urban Development (HUD) recognizes the benefits of emotional support animals and provides regulations allowing them to live with an owner in designated nonpet housing (with a few exceptions) without requiring a pet deposit fee.

Exercising this right does not require that an animal be certified. What it does require is documentation that an individual has a legitimate need for an emotional support animal. The responsibility of providing this documentation lies with professional counselors and other mental health or health providers. In 2008, HUD stipulated that “persons who are seeking a reasonable accommodation for an emotional support animal may be required to provide documentation from a physician, psychiatrist, social worker or other mental health professional that the animal provides support that alleviates at least one of the identified symptoms or effects of the existing disability.”

Documentation and other considerations

A counselor who chooses to provide such documentation must do so in letter format on the counselor’s letterhead. The documentation should state that:

1) The named individual is under the counselor’s care

2) The individual has an emotional or psychiatric disability

3) The counselor recommends the individual have an emotional support animal to assist with the disability

The letter is provided directly to the individual who wants to have an emotional support animal live in the home. The individual can then choose with whom to share the letter.

In the documentation, the counselor does not label, define or describe the particular disability of the client. Rather, the counselor must state in general terms that the client has an emotional or psychiatric disability and that an emotional support animal can alleviate one or more of the symptoms or effects of the disability. Individuals need only provide proper documentation to a landlord to have a pet live with them as an emotional support animal in housing typically designated as excluding pets. The judicial system has interpreted this right to fair housing to additionally extend to individuals who wish to have emotional support animals live with them in college or university housing facilities, such as residence halls, dormitories or university-owned apartments.

The responsibility of providing documentation that would allow individuals to have an emotional support animal live with them should not be taken lightly. Based on the accompanying symptoms of a client’s emotional or psychiatric disability, a professional must determine whether living and engaging with an emotional support animal in the home might provide the client with some relief from the disability. To make this determination, it may be useful to have some understanding of how an animal may alleviate symptoms or effects of an emotional disability. Fortunately, there is research that provides guidance in this area.

In my 2012 book, Animal Assisted Therapy in Counseling, I reviewed several research studies on the psychophysiological and psychosocial benefits of positive social interaction with a pet, such as holding or stroking an animal. These benefits include calming and relaxing, lowering anxiety, alleviating loneliness, enhancing social engagement and interaction, normalizing heart rate and blood pressure, reducing pain, reducing stress, reducing depression and increasing pleasure. Based on the results of these studies, it is plausible that living with an emotional support animal may alleviate symptoms associated with a number of emotional and psychiatric disabilities. HUD states, “Emotional support animals by their very nature, and without training, may relieve depression and anxiety, and/or help reduce stress-induced pain in persons with certain medical conditions affected by stress.”

Another factor to consider in recommending that a client have an emotional support animal is whether the client has the ability and desire to properly care for an animal. Although human-animal interaction is known to assist people with developmental, emotional, social and behavioral disorders, it is important to assess whether any impairment is so severe that an animal would be neglected or harmed.

Dogs are the most common species to serve in the role of emotional support animals, but Section 504 of the Rehabilitation Act and HUD’s Fair Housing Act (FHAct) do not designate species restrictions for this role: “While dogs are the most common type of assistance animal, other animals can also be assistance animals.”

Emotional support animals vs. service animals

HUD legislation uses the broad term “assistance animals,” which is inclusive of both service animals and emotional support animals, when addressing the right to fair housing for individuals with these animals. In contrast, the fair housing rights and rights of access to other facilities included in the Americans with Disabilities Act addresses service animals only. To be clear, an emotional support animal is not the same as a service animal or a psychiatric service animal. Thus, emotional support animals do not have the same federal rights of access to facilities as do service animals. HUD provides the only current federal legislation that covers rights regarding emotional support animals, and this legislation is specific to allowing individuals to have animals live with them as emotional support in designated nonpet housing without financial penalty.

In 2013, HUD clarified that an emotional support animal is not merely a pet: “An assistance animal is not a pet. It is an animal that works, provides assistance or performs tasks for the benefit of a person with a disability, or provides emotional support that alleviates one or more identified symptoms or effects of a person’s disability.” However, HUD also stipulated that emotional support animals “do not need training to ameliorate the effects of a person’s mental and emotional disabilities.” Furthermore, “For purposes of reasonable accommodation requests, neither the FHAct nor Section 504 requires an assistance animal to be individually trained or certified.”

There are no qualification requirements for determining whether a specific pet is appropriate to serve as an emotional support animal. So, by default, an emotional support animal is basically a person’s pet that lives with that person and provides emotional support. HUD does stipulate that housing providers are not required to provide accommodations if an animal is destructive, poses a direct threat to the health and safety of others or interferes with the ability of a facility to perform its intended purpose. So, in practice, most people with proper documentation can have a pet live with them and serve in the role of emotional support animal as long as the animal is not destructive, disruptive or dangerous.

Recommendations

Because federal law does not require emotional support animals to be trained or certified, the potential exists for some of these animals to be unpredictable and cause harm. Until there is greater oversight regarding emotional support animals, I recommend that counselors avoid a chain of liability and not name a specific pet to serve as an emotional support animal. When providing documentation, refer only to the benefit of the individual having an emotional support animal, but do not name a specific animal. The decision concerning the specific pet to be designated as an emotional support animal should be made by the individual owner of the pet. It is not the responsibility of the counselor or other mental health provider to sanction the appropriateness of a particular pet to serve as an emotional support animal. That is not to say that counselors should avoid assisting individuals in the decision-making process regarding emotional support animals.

For instance, counselors can recommend that clients have their pets evaluated by a qualified evaluator before designating the pets to serve as emotional support animals. A standardized evaluation can often determine if an animal possesses the appropriate stamina and temperament to serve in this role.

Evaluation is important for health and safety reasons. Some animals may find the role of emotional support animal to be too stressful, and the emotional and physical health of the pet will be damaged. We must not overlook the welfare of the animals when considering whether they might provide emotional support for individuals with emotional and psychiatric disabilities. In addition, some pets can respond to stress with overprotective tendencies and aggression, putting members of the public at risk.

Many individuals desire to have their emotional support animals accompany them to pet-restricted facilities outside the home. Many businesses and institutions today are wrestling with how to make this happen while still maintaining the safety of those who may come in contact with these animals. It is my opinion, as a very experienced handler and animal team evaluator, that if individuals were to have their pets’ temperament evaluated by a qualified evaluator, both initially and periodically (say every two years), and provide current documentation that the animal had passed a standardized temperament evaluation, then they might be granted permission by a business or institution on a case-by-case basis to have their emotional support animal accompany them to places where pets are typically not allowed.

Animal temperament evaluations

Animal temperament evaluations assess the animal’s social attitude and behavior toward both people and a neutral test dog. In addition, the evaluation assesses the animal’s ability to walk politely on a leash, interact with a small crowd of people and respond to a variety of basic obedience commands by its handler. Failing a temperament evaluation would not interfere with the right of an individual to have the pet live in the home in the role of emotional support animal. Federal law protects this right. Qualified animal temperament evaluators can be found through national organizations such as the American Kennel Club (AKC) Canine Good Citizen (CGC) program and the national Pet Partners program.

The AKC website (akc.org/dog-owners/training/canine-good-citizen/) provides information about the CGC evaluation, which is best suited for the simple purpose of determining if a pet is well-behaved enough to be around the general public. However, it is designed solely to evaluate the temperament of dogs, not other species. The CGC evaluation is relatively inexpensive, takes about 30 minutes to complete and requires the handler to take the dog through a series of basic obedience commands. Local CGC evaluators can be found at many large pet stores that offer dog training for handlers or at community obedience training clubs. The Pet Partners organization offers evaluations for a number of different domestic animal species, but the investment in cost and effort is higher. This is because the intended purpose is to register Pet Partners teams that can provide services to the public as handler and therapy animal (note that a therapy animal is not the same as an emotional support animal). The Pet Partners registration requires a rigorous handler-team evaluation — for temperament, skills and aptitude — and requires the handler to complete a training that is available online or through an eight-hour, in-person workshop. The training includes learning about risk management and infection control procedures that are valuable to follow when a pet is engaging with the public. The Pet Partners website (petpartners.org) provides information on training and finding a local evaluator.

The animal temperament evaluation procedure may resolve a prominent ethical dilemma. If an emotional support animal can alleviate or assist with a person’s emotional or psychiatric disability at home, why shouldn’t the animal be allowed to serve this purpose outside of the home as well, such as in the classroom or a work environment? At the same time, because no oversight exists regarding behavioral requirements for emotional support animals, how do businesses and institutions protect the public from danger posed by a potentially unruly animal? Because there is no federal regulation that requires facilities other than housing to allow the presence of emotional support animals, then businesses and institutions can establish their own policies around this issue.

Requiring a standardized animal temperament evaluation may be a reasonable solution to this ethical quandary. The business or institution could provide a letter of access, for a designated period of time, to an individual accompanied by an emotional support animal if that person provides the institution with:

1) Official documentation from a professional counselor, or other mental health or health provider, designating the need for an emotional support animal (this could be the same documentation used for federal housing rights)

2) Proof that the animal passed a recently administered standardized temperament evaluation from a reputable source such as AKC or Pet Partners (the evaluation should have been completed within the past two years because appropriate animal temperament can deteriorate over time)

Advocacy

Perhaps the greatest source of confusion today is around the concept of emotional support animals. The general public may not be aware that emotional support animals are not the same as psychiatric service animals and therefore do not have all of the same federal rights to access facilities. Many people are unaware that current federal law does not require emotional support animals to be trained or evaluated. Thus, some emotional support animals with inappropriate temperament may pose a risk to the general public. Generally, the public does not realize that most emotional support animals are essentially a person’s pet serving in the role of emotional support.

I am an advocate for the idea of emotional support animals, but I firmly believe there should be greater oversight. This would include evaluation of the appropriateness of a pet to serve as an emotional support, taking into consideration both the prospective health and welfare of the animal and the health and welfare of the public, particularly if the animal is to accompany the individual to facilities outside the home. Current federal law clearly states that an emotional support animal does not have to be trained or certified to be allowed to live with a person, implying that the animal does not have to be evaluated either. But federal law does not make stipulations about access to facilities other than the home for emotional support animals. Thus, businesses and institutions are free to make policies that allow individuals to be accompanied by their emotional support animals, while also providing for the safety of the public.

Counselors can more effectively advocate for their clients if they understand federal regulations pertaining to emotional support animals. Additionally, this information is beneficial for protecting the general public from those who might misrepresent the role of their animal or the right for the animal to accompany them into pet-restricted areas. Unfortunately, profit opportunists exist who encourage such misrepresentation by selling (to anyone who is willing to pay) an official-looking — yet completely unofficial — vest for a pet to wear and a worthless “certification” document that may ultimately confuse the public about the legitimate role of the animal and the rights of the individual the animal is accompanying.

Federal advocacy for those with emotional or psychiatric disabilities, through recognition of the right to have an emotional support animal in the home, is a positive development in our society. Moreover, businesses and institutions that recognize the potential benefits of allowing an emotional support animal to accompany a person with a disability outside of the home reflects enhanced sensitivity to human welfare.

Animals are an excellent source of nurturance and companionship. Creating additional yet responsible opportunities for human-animal interaction enhances people’s lives. Movement toward greater integration of well-behaved animals into our daily lives at home, school and work is a reflection of enlightened social evolution.

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Cynthia Chandler is a professor of counseling and director of the Consortium for Animal Assisted Therapy at the University of North Texas. She is author of the book Animal Assisted Therapy in Counseling (2012). Contact her at cynthia.chandler@unt.edu.

As counselors know, the ethical and legal requirement of the “duty to warn” has been adopted as a standard of care across many helping professions. It probably represents one of the most universal elements of counseling ethics regardless of cultural or national identity. Based on the Hippocratic notion of “first, do no harm” or avoidance of malfeasance, this duty is considered strong enough to override considerations of client confidentiality. In the 2014 ACA Code of Ethics, Standard B.2.a. notes that confidentiality is not guaranteed “when disclosure is required to protect clients or identified others from serious and foreseeable harm.”

Unfortunately, the ACA Code of Ethics does not define harm, which could conceivably encompass financial fraud, verbal abuse, sexual seduction or unjustified termination of employment. But even more noticeably absent is any explicit duty to warn or protect should a client self-disclose current or future intent to maliciously injure animals or elements of the natural environment. These are excluded from the category of “identified others.”

I would like to present the case that a species-centric definition of such “others” requires serious re-examination given a number of important developments:

Neurobiological research on animal consciousness and experiences of pain

The promotion of animal-assisted psychotherapy and counseling

The growth of the animal rights movement and increased attention to humane slaughtering practices

Greater awareness of the mental health benefits of animal companionship

In general, it appears contradictory, if not hypocritical, to employ animals as co-partners in counseling and therapy while not defending their welfare within the context of counselor-client relationships.

Extending our ethical considerations

Much of our profession’s ethics, such as the core value of autonomy, rests on the formal philosophy of Immanuel Kant. His theories taught that moral agents should be treated as ends in themselves rather than means to an end. Avoiding exploitative relationships, maintaining confidentiality, providing competent services, avoiding and correcting discriminatory practices, and respecting the rights of research participants all reflect the Kantian emphasis on the intrinsic value of the individual as an ultimately self-defining “who” rather than a “what.” Even the use of the term duty in ethical codes comes directly from Kant.

The injunction to recognize and respect the subjectivity of each client argues for the most basic ethical adage, “Do unto others as you would have them do unto you.” It also encourages those empathic insights and sense of “fellow-feeling” that are so crucial to the therapeutic alliance. You cannot act upon the Golden Rule without a basic recognition that others experience pain in ways similar to, if not identical to, you.

A similar idea underlies Martin Buber’s distinction between relationships based on the authentic “I-Thou” and the impersonality of “I-It.” That existential perspective has also shaped much of psychotherapy. In terms of psychopathology, the inability to experience interpersonal empathy often indicates narcissistic, sociopathic and antisocial personality disorders. Even Kant argued that cruelty to animals deadens feelings of compassion in people.

Unfortunately for animals, Kant did not extend his ethical considerations to non-human beings. Like most Enlightenment thinkers, he believed that only humans demonstrate the logical capacity and free will to act as moral agents. This line of thought was preceded by rationalist philosophers from Aristotle to Descartes, and metaphysicians from Plato to Judeo-Christian theologians who denied that animals possess consciousness or a soul.

But surely we as counselors should refute this perspective. For starters, the standard of full rationality and free will doesn’t entirely fit clients who are dealing with thought disorders, depression, developmental disabilities, schizophrenia and schizoaffective disorder, autism spectrum disorders, Alzheimer’s, states of intoxication or, for that matter, childhood and adolescence. Yet those whom philosophers ill-advisedly called “marginal human beings” enjoy full respect and protection under the ACA Code of Ethics.

Furthermore, current research in ethology, primatology, comparative neurology and consciousness studies increasingly demonstrates that moral consciousness is a difference of degree rather than kind. An increasing number of studies provide evidence for various dimensions of mental complexity across several species, including schema construction, tool making and use, abstract reasoning, self-consciousness and mathematical abilities. Highly social and mutually cooperative animals such as those that congregate in extended families, herds or troops demonstrate empathy, altruism, forgiveness, levels of ethical decision-making and perhaps that most social and moral emotion of all — shame. Examples include rodents, canines, elephants, chimpanzees, orangutans and baboons.

The evidence that animals experience pain is growing rapidly as well, even as it still generates considerable debate. Whatever one’s personal stance on this issue, modern animal-handling techniques recognize the importance of considering such questions in actual practice. The increased use of humane slaughter and hunting techniques, championed by Temple Grandin and others, is based on measurable indicators of suffering such as neurochemical stress reactions and learned avoidance of pain. The American College of Veterinary Anesthesiologists has also considered this matter deeply and issued a list of behavioral and physiological indicators of animal distress.

Protecting our counseling colleagues

Even more directly, the use of non-human beings as adjuncts or co-therapists is acknowledged under labels such as “animal-assisted activities” (AAA) and “animal-assisted therapy” (AAT). It has long been noted that the simple companionship of domesticated animals helps reduce human stress levels, lowers blood pressure and elevates morale and feelings of well-being. Animal-based counseling practices take these benefits to higher levels. AAA and AAT currently employ a long list of species, including dogs, horses, rabbits, birds, reptiles and fish.

Section D of the ACA Code of Ethics (“Relationships With Other Professionals”) lays out specific obligations counselors have to their professional colleagues. The introduction to this section states in part, “Counselors develop positive working relationships … with colleagues to enhance services to clients.” Standards D.1.b. (“Forming Relationships”), D.1.d. (“Establishing Professional and Ethical Obligations”) and D.1.h. (“Negative Conditions”) carry these implications forward as well.

To pose the question directly, how have animals not served as colleagues to the counseling profession? From the development of behaviorist theories to clinical trials of psychotropic medications, from Harry Harlow’s experiments on social isolation with rhesus monkeys to neurosurgery studies on brain function, animals have been recruited to provide important insights into learning, sociability, substance and process addiction, and the proper use of psychopharmaceuticals.

In practice it seems difficult to defend any human counselor who employs non-human adjuncts yet fails to act on behalf of their welfare. The continuity and emotional bonding of the client-assistive animal relationship obviously depends on the health and longevity of the animal in question. In these sorts of relationships, animals are not interchangeable. Clients would surely suffer from grief reactions due to the sickness, injury or death of individual non-human companions or co-therapists.

Moral considerations aside, it’s self-defeating to ignore the documented and even predictive associations between animal torture and serious psychopathology. There are high levels of uncertainty in forecasting client violence, but a growing body of evidence links animal cruelty to antisocial personality disorder, antisocial personality traits, polysubstance abuse and potential for serial homicide. Malicious harm to animals also appears indicative of early childhood trauma, current domestic violence and developmental disabilities. Animal hoarding often symptomizes obsessive-compulsive or borderline personality disorders. The extent of these associations is so high that many states mandate psychiatric assessment for all individuals charged with violating animal cruelty laws.

Other considerations

Critics may object that an animal-protective policy fails to respect cultural sensitivities. So-called blood sports have enjoyed popularity around the globe. The animals involved in staged gladiatorial contests range from bulls and cocks to dogs, rats, fish and even insects. The most hotly debated example remains the corridas, or bullfights, that some have branded as sadistic but that proponents defend as central to Spanish and Mexican national identity. Fox hunting has raised parallel concerns in the United Kingdom. Animal racing and rodeos are subject to similar controversies.

Yet amateur and professional associations of hunters, anglers, circus owners, race course owners, rodeo and bull fight organizers and even pest exterminators have published ethical guidelines meant to minimize pain to creatures that are either used for sport or subject to systematic killing. Fans of corridas, for example, prize the “clean kill,” just as ethical hunters advocate the doctrine of “fair chase.” Fly fishers argue for “catch and release,” while the United Kingdom’s Masters of Foxhounds Association insists that quarry be “quickly and humanely dispatched.” If such organizations provide ethical protection for animals, why should the American Counseling Association lag behind?

It must be noted that attention to the welfare of animals does not guarantee empathy for fellow human beings. One of the strictest and most comprehensive pieces of governmental legislation in this area was the 1933 law on animal protection, enacted by the top leadership of Nazi Germany. Almost immediately after coming into power, the Third Reich banned vivisection and tail docking, animal trapping, the killing of wolves and inhumane slaughter practices. The Nazis also promoted public school education in support of these policies.

Thus, extending consideration to animals does not by itself ensure the ethical treatment of people. But with the ACA Code of Ethics so firm in its resolve to underscore the universality of human rights and welfare, this historical aberration need not determine the limits of moral discourse. To the contrary, it should encourage a greater respect for the variety and multitude of creatures that experience a demonstrable inwardness and subjectivity.

Considering animal welfare encourages more deliberate and contextual thinking about how counseling clients function within their own web of significant relationships that includes family, occupation, political structures, mental health care delivery systems and the natural environment. But the counseling profession, like so many others, generally operates in an urbanized society characterized by an increasing separation of people from nature. Consider that even in the “Dimensions of Personal Identity” document that used to be offered on the ACA website, relationships with biota were never specified. And the place of animals in people’s lives was barely touched upon in the CACREP-accredited program from which I graduated. Yet, ironically, ecotourism opportunities and appeals to travel to unspoiled wilderness areas are sometimes touted in advertisements for ACA annual conference sites.

What all of this argues for is incorporation of animal-related considerations into any future drafts of the ACA Code of Ethics. At the very least, it urges all counselors and counseling agencies to adopt specific policies within their practices. For example, under my personal “statement of clients’ rights” that each client signs after review, we list the standard reasons for violating confidentiality. But we also add the following: “Please note that if clients reveal current or intended malicious harm to animals such as torture or neglect, we will need to consider reporting such activity to law enforcement or animal protection agencies.”

To date, I have never had to violate confidentiality on the basis of any client self-disclosing deliberate and malicious harm to animals. But at the very least, the policy does serve as a reminder of the essential “creatureliness” that clients and clinicians share as we engage in treatment together. It also reminds us that the genuine love that clients and animals often share for each other offers a model for experiencing trust, deep connection, unconditional love, pleasure, play and perhaps even joy. Such a wellspring of healing deserves the protection of ethical principles and professional practices.

Perhaps ACA will eventually recognize this in formal policy terms, having missed the opportunity in the 2014 revision of its ethics code. Until that day, those of us in private and agency practice can move ahead on our own.

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Peter Wollheim is a licensed professional counselor in Idaho and the founder of Mental Health Boise. Contact him at peter@mhboise.com.